BIO-MEDICAL WASTE MANAGEMENT

2. BIO-MEDICAL WASTE MANAGEMENT ”

3. Let the waste of the “sick” not contaminate the lives of “The Healthy” Dr kamal Deep J.R. First Year

4. Definition • Acc to bio medical waste rules ,1998 of India “ Bio-medical waste” means any waste which is generated during the diagnosis, treatment or immunization of human beings or animals or in research activities pertaining there to or in the production or testing of bio medicals. Hospital waste:refers to all waste, biological or non biological, that is discarded and is not intended for further use Medical waste: refers to materials generated as a result of patient diagnoses, treatment, immunization of human beings or animals

5. Sources of health care waste • Government/private hospitals • Nursing homes • Physician/dentist office or clinic • Dispensaries • Primary health care centers • Medical research and training centers • animal./slaughter houses • labs/research organizations • Vaccinating centers • Bio tech institutions/production units

6. BIOMEDICAL WASTE MANAGEMENT & HANDLING RULE • Came into force on 28th july,1988. • Prescribed by Ministry of environment & forest under the environment protection act of India. • It safeguard the public & the health care workers from the risk arising due to biomedical waste. • This rule apply to all persons who generate ,collect, receive, store, transport, treat, dispose or handle biomedical waste in anyform. • Waste shall be treated & disposed of in accordance with schedule 1, and with the standards prescribed in schedule V. • Biomedical waste shall be segregated into containers / bags at the point of generation in accordance with schedule II prior to its storage, treatment , transportation & disposal. The containers shall be labelled according to schedule III.

7. CLASSIFICATION

8. MAGNITUDE OF THE PROBLEM GLOBALLY- Developed countries generate 1 to 5 kg/bed/day Developing countries: meager data, but figures are lower. 1-2kg/pt./day • WHO Report: 85% non hazardous waste : 10% infective waste : 5% non-infectious but hazardous. (Chemical, pharmaceutical and radioactive) INDIA:-No national level study - local or regional level study shows hospitals generate roughly 1-2 kg/bed/day

9. CATEGORIES OF BIOMEDICAL WASTE SCHEDULE – I

12. POINTS TO REMEMBER • @ : There wil be no chemical pretreatment before inciniration. Chlorinated plastics shall not be incinerated. • * Deep burial shall not be option available only in town with population less than 5 lac & in rural area. • @@ chemicals treatment using atleast 1% hypochlorite solution or any other equivalent chemical reagent. It must be ensured that chemical treatment ensures disinfection. • # Multilation/ shredding must be such so as to prevantunauthorised reuse. • ^^ About 4-250 litre/bed/day.

13. SOLID WASTE • About 0.3-3.5 kg/bed/day 1: GARBAGE-55% 2:BMW • A) wasted body remains blood,cultures, anatomical waste -5% • B)Pharmaceutical &chemical waste-2% • C)Pathological waste-06% 3: Sharp object -20% 4:Pressurized container & discarded instruments- 2% 5: Radioactive wastes-0.3

15. WASTE SEGREGATION

16. Waste collection bags for waste type needing incineration shall not be made of chlorinated plastics. • Categories 8 & 10(liquid) do not require containers / bags • Body fluids like pleural fluid are mixed with 1% bleaching powder & then disposed off. • Cat 3 if disinfected locally need not to be put in containers / bags.

17. Hospital waste disposal

18. Steps To Manage Hazardous Wastes Before Disposal 1. Know what hazards you have 2. Purchase smallest quantity needed, and don’t purchase hazardous materials if safe alternative exists **Use mercury-free thermometers

19. Steps to Manage Hazardous Wastes (cont’d) 3. Limit use and access to trained persons with personal protective gear

20. Get Rid of Unnecessary Stuff • Don’t accumulate unneeded products • Don’t let peroxides and oxidising agents turn into bombs Photo of bomb robot called into hospital to dispose of picric acid.

21. Label with Agent, Concentration and Hazard Warnings • Examples of hazard labels:

22. Communicate about Workplace Hazards • Job description • Posters on doors • Labels on hazards • Give feedback on use of PPE and disposal in evaluation • Role model safe use and disposal • Contact point who is responsible

23. Recycle Products When Possible

26. ROTARY KILN PYROLYTIC INCINERATOR

28. SINGLE CHAMBER INCINERATOR DRUM/BRICK INCINERATION

30. CHEMICAL DISINFECTION

31. WET THERMAL TREATMENT Off-site wet thermal (or "steam autoclave") treatment facility

33. MICROWAVE IRRADIATION

35. ENCAPSULATION

36. Inertisation, Immobilisation

37. BIOMEDICAL WASTE MANAGEMENT IN TBHP • In our hospital there is 7 generation point of waste where biomedical waste is segregated into different buckets containing polythene of same color as bucket. • The generation points are: • Emergency • Ward 4 • Ward 6 • ICU • Operation theatre • Labortory • Room no 10 • From each generation point waste is carried to central point which is emergency of TBHP. • There waste in different polythene bag is weighed and tag is applied to the bag. • Waste from TBHP is managed by SembRamky Environment pvt ltd. Luidhana where waste is treated in bioplant.

38. Conclusion • Thus refuse disposal cannot be solved without public education. • Individual participation is required. • Municipality and government should pay importance to disposal of waste economically. • Thus educating and motivating oneself first is important and then preach others about it. • Start disposing waste first from within your home, then outside home, then neighborhood ,then your street, your area ,city and then the nation and the world. • Lets make this world a better place to live in.

39. This World belongs to me. And to you. And to your children. It's ours. THANK YOU HCRW Management.ppt 7/03